Psilocybin-Assisted Therapy: A scoping review of participants’ and facilitators’ experiences in qualitative studies
DOI:
https://doi.org/10.33448/rsd-v12i9.43308Keywords:
Psilocybin; Psychedelic mushroom; Psilocybin-assisted therapy; Scoping review; Experiences; Qualitative research.Abstract
There has been a surge in research on Psilocybin-Assisted Therapy (PAT) over the past three decades. PAT has yielded positive results across clinical trials and demonstrated efficacy in treating various mental disorders. However, limited qualitative research exists that explores peoples’ experiences of PAT. This study aims to review the current literature on the experiences of individuals that have participated in PAT, as well as individuals that have facilitated PAT. This study aims to increase our understanding of PAT to guide and improve therapeutic effectiveness. A scoping review was conducted from English language studies published in peer-reviewed journals. Searches were conducted from PsycInfo, CINAHL, PubMed, Web of Science, and Cochrane Library databases. Inclusion criteria were qualitative studies involving PAT that were conducted between January 1990 and December 2022; articles published in peer-reviewed journals; and psychedelic practitioners’ experiences of facilitating PAT. In total, 13 articles were extracted to be included in the review. Articles were published between 2017 and 2021, and were divided into (1) Participant Studies (10) and (2) Facilitator Studies (3). Six themes were identified: the influence of set and setting; PAT was personalised and meaningful; PAT can be highly emotive; transcendental experiences; reduction of symptoms and long-lasting changes; and boundaries and responsibility. The literature revealed numerous interrelated therapeutic elements that may have contributed to a meaningful experience during PAT. This may play a role in attaining long-lasting positive therapeutic outcomes. The studies were varied and highlighted the usefulness of further exploring PAT.
References
Agin-Liebes, G., Ekman, E., Anderson, B., Malloy, M., Haas, A., & Woolley, J. (2021). Participant reports of mindfulness, posttraumatic growth, and social connectedness in psilocybin-assisted group therapy: An interpretive phenomenological analysis. Journal of Humanistic Psychology, 1-28. https://doi.org/10.1177/00221678211022949
Al-Naggar, R. A., Alshaikhli, H., & Erlam, G. (2021). Effectiveness of psilocybin on depression: A qualitative study. Electronic Journal of General Medicine, 18(3), 3–9. https://doi.org/10.29333/ejgm/10862
Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Barrett, F. S., Robbins, H., Smooke, D., Brown, J. L., & Griffiths, R. R. (2017). Qualitative and quantitative features of music reported to support peak mystical experiences during psychedelic therapy sessions. Frontiers in Psychology, 8, 1-12. https://doi.org/10.3389/fpsyg.2017.01238
Belser, A. B., Agin-Liebes, G., Swift, T. C., Terrana, S., Devenot, N., Friedman, H. L., & Ross, S. (2017). Patient experiences of psilocybin-assisted psychotherapy: An interpretative phenomenological analysis. Journal of Humanistic Psychology, 57(4), 354–388. https://doi.org/10.1177/0022167817706884
Bienemann, B., Ruschel, N. S., Campos, M. L., Negreiros, M. A., & Mograbi, D. C. (2020). Self-reported negative outcomes of psilocybin users: A quantitative textual analysis. PLoS ONE, 15(2), 1–14. https://doi.org/10.1371/journal.pone.0229067
Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A., Wilcox, C. E., Barbosa, P., & Strassman, R. J. (2015). Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study. Journal of Psychopharmacology, 29(3), 289–299. https://doi.org/10.1177/0269881114565144
Bogenschutz, M. P., Podrebarac, S. K., Duane, J. H., Amegadzie, S. S., Malone, T. C., Owens, L. T., & Mennenga, S. E. (2018). Clinical interpretations of patient experience in a trial of psilocybin-assisted psychotherapy for alcohol use disorder. Frontiers in Pharmacology, 9(FEB), 1–7. https://doi.org/10.3389/fphar.2018.00100
Breeksema, J. J., Niemeijer, A., Krediet, E., Vermetten, E., & Schoevers, R. (2020). Psychedelic treatments for psychiatric disorders: A systematic review and thematic synthesis of patient experiences in qualitative studies. CNS Drugs. https://doi.org/10.1007/s40263-020-00748-y
Brennan, W., Jackson, M. A., MacLean, K., & Ponterotto, J. G. (2021). A qualitative exploration of relational ethical challenges and practices in psychedelic healing. Journal of Humanistic Psychology, September, 1-31. https://doi.org/10.1177/00221678211045265
Carhart-Harris, R. L., Bolstridge, M., Day, C. M. J., Rucker, J., Watts, R., Erritzoe, D. E., & Nutt, D. J. (2018). Psilocybin with psychological support for treatment-resistant depression: Six-month follow-up. Psychopharmacology, 235(2), 399–408. https://doi.org/10.1007/s00213-017-4771-x
Carhart-Harris, R. L., Bolstridge, M., Rucker, J., Day, C. M. J., Erritzoe, D., Kaelen, M., & Nutt, D. J. (2016). Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study. The Lancet Psychiatry, 3(7), 619–627. https://doi.org/10.1016/S2215-0366(16)30065-7
Coleman, R., & Walker, M. (2017). Psychedelic psychotherapy: A user friendly guide to psychedelic drug-assisted psychotherapy. Transform Press. https://books.google.co.za/books?id=yjmhswEACAAJ
Dorsen, C., Palamar, J., & Shedlin, M. G. (2019). Ceremonial ‘Plant Medicine’ use and its relationship to recreational drug use: An exploratory study. Addiction Research & Theory, 27(2), 68–75. https://doi.org/10.1080/16066359.2018.1455187
Fadiman, J. (2011). The psychedelic explorer’s guide: Safe, therapeutic and sacred journeys. Park Street Press.
Frecska, E. (2011). The risks and potential benefits of ayahuasca use from a psychopharmacological perspective. In B. C. Labate (Ed.). The Internationalization of Ayahuasca (151-165). Lit Verlag. https://doi.org/10.13140/RG.2.1.1939.9286
Goldsmith, M. N. (2010). Psychedelic healing: The promise of entheogens for psychotherapy and spiritual development. Healing Arts Press.
Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181–1197. https://doi.org/10.1177/0269881116675513
Grob, C. S., Danforth, A. L., Chopra, G. S., Hagerty, M., McKay, C. R., Halberstad, A. L., & Greer, G. R. (2011). Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Archives of General Psychiatry, 68(1), 71–78. https://doi.org/10.1001/archgenpsychiatry.2010.116
Grof, S. (2008). Brief history of transpersonal psychology. International Journal of Transpersonal Studies, 27(1), 46–54. http://dx.doi.org/10.24972/ijts.2008.27.1.46
Grof S. (2008). LSD Psychotherapy: The Healing Potential of Psychedelic Medicine. Multidisciplinary Association for Psychedelic Studies.
Grof, S. (2019). The way of the psychonaut: Encyclopedia for inner journeys (Vol 1). Multidisciplinary Association for Psychedelic Studies.
Guthrie, L. (2021). A phenomenology of challenging psychedelic experiences: From relational trauma to relational healing (Doctoral dissertation, Duquesne University). ProQuest Dissertations and Theses.
Hayes, C., Wahba, M., & Watson, S. (2022). Will psilocybin lose its magic in the clinical setting? Therapeutic Advances in Psychopharmacology, 12, 1-9. https://doi.org/10.1177/20451253221090822
Johnson, M. W., & Griffiths, R. R. (2017). Potential therapeutic effects of psilocybin. Neurotherapeutics,14(3), 734–740. https://doi.org/10.1007/s13311-017-0542-y
Johnson, M. W., Richards, W. A., & Griffiths, R. R. (2008). Human hallucinogen research: Guidelines for safety. Journal of Psychopharmacology, 22(6), 603–620. https://doi.org/10.1177/0269881108093587
Kaelen, M., Giribaldi, B., Raine, J., Evans, L., Timmerman, C., Rodriguez, N., & Carhart-Harris, R. (2018). The hidden therapist: Evidence for a central role of music in psychedelic therapy. Psychopharmacology, 235(2), 505–519. https://doi.org/10.1007/s00213-017-4820-5
Lehto, R. H., Miller, M., & Sender, J. (2022). The role of psilocybin-assisted psychotherapy to support patients with cancer: A critical scoping review of the research. Journal of Holistic Nursing, 40(3), 265–280. https://doi.org/10.1177/08980101211039086
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ, 339, 1-10. https://doi.org/10.1136/bmj.b2700
Lutkajtis, A. (2021). Four individuals’ experiences during and following a psilocybin truffle retreat in the Netherlands. Journal of Psychedelic Studies, 5(1), 22–32. https://doi.org/10.1556/2054.2021.00162
Malone, T. C., Mennenga, S. E., Guss, J., Podrebarac, S. K., Owens, L. T., Bossis, A. P., & Ross, S. (2018). Individual experiences in four cancer patients following psilocybin-assisted psychotherapy. Frontiers in Pharmacology, 9, 1-6. https://www.frontiersin.org/articles/10.3389/fphar.2018.00256
Mason, N. L., Mischler, E., Uthaug, M. V., & Kuypers, K. P. C. (2019). Sub-acute effects of psilocybin on empathy, creative thinking, and subjective well-being. Journal of Psychoactive Drugs, 51(2), 123–134. https://doi.org/10.1080/02791072.2019.1580804
McCartney, A. M., McGovern, H. T., & De Foe, A. (2022). Psychedelic assisted therapy for major depressive disorder: Recent work and clinical directions. Journal of Psychedelic Studies, 6(1), 10–22. https://doi.org/10.1556/2054.2022.00211
Meikle, S. E., Liknaitzky, P., Rossell, S. L., Ross, M., Strauss, N., Thomas, N., & Castle, D. J. (2020). Psilocybin-assisted therapy for depression: How do we advance the field? Australian & New Zealand Journal of Psychiatry, 54(3), 225–231. https://doi.org/10.1177/0004867419888575
Moreno, F. A., Wiegand, C. B., Taitano, E. K., & Delgado, P. L. (2006). Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. Journal of Clinical Psychiatry, 67(11), 1735–1740. https://doi.org/10.4088/JCP.v67n1110
Nielson, E. M., May, D. G., Forcehimes, A. A., & Bogenschutz, M. P. (2018). The psychedelic debriefing in alcohol dependence treatment: Illustrating key change phenomena through qualitative content analysis of clinical sessions. Frontiers in Pharmacology, 9, 1-13. https://doi.org/10.3389/fphar.2018.00132
Nielson, E. M., & Guss, J. (2018). The influence of therapists’ first-hand experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training. Journal of Psychedelic Studies, 2(2), 64–73. https://doi.org/10.1556/2054.2018.009
Noorani, T., Garcia-Romeu, A., Swift, T. C., Griffiths, R. R., & Johnson, M. W. (2018). Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts. Journal of Psychopharmacology, 32(7), 756–769. https://doi.org/10.1177/0269881118780612
Nutt, D. (2019). Psychedelic drugs - A new era in psychiatry? Dialogues in Clinical Neuroscience, 21(2), 139–147. https://doi.org/10.31887/DCNS.2019.21.2/dnutt
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan — a web and mobile app for systematic reviews. Systematic Reviews, 5(210), 1-10 https://doi.org/10.1186/s13643-016-0384-4
Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119–2126. https://doi.org/10.11124/JBIES-20-00167
Pollan, M. (2018). How to change your mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence. Penguin Books.
Phelps, J., & Henry, J. (2021). Foundations for training psychedelic therapists. Springer. https://doi.org/10.1007/7854_2021_266
Radakovic, C., Radakovic, R., Peryer, G., & Geere, J. A. (2022). Psychedelics and mindfulness: A systematic review and meta-analysis. Journal of Psychedelic Studies, 6(2), 137–153. https://doi.org/10.1556/2054.2022.00218
Read, T., & Papaspyrou, M. (2021). Psychedelics and psychotherapy: The healing potential of expanded states. Park Street Press.
Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., & Schmidt, B. L. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial. Journal of Psychopharmacology, 30(12), 1165–1180. https://doi.org/10.1177/0269881116675512
Schultes, R. E., Hoffman, A., & Rätsch, C. (2001). Plants of the Gods: Their sacred, healing, and hallucinogenic powers. Healing Arts Press.
Shaw, L., Rea, K., Lachowsky, N. J., & Roth, E. A. (2022). Magic mushroom use: A qualitative interview study of post-trip impacts and strategies for optimizing experiences. Journal of Psychoactive Drugs, 1–8. https://doi.org/10.1080/02791072.2022.2054746
Shore, R. J., Ioudovski, P., McKeown, S., Dumont, E., & Goldie, C. (2019). Mapping psilocybin-assisted therapies: A scoping review. MedRxiv. https://doi.org/10.1101/2019.12.04.19013896
Smith, W. R., & Appelbaum, P. S. (2022). Novel ethical and policy issues in psychiatric uses of psychedelic substances. Neuropharmacology, 216, 1-5. https://doi.org/10.1016/j.neuropharm.2022.109165
Soler, J., Elices, M., Dominguez-Clavé, E., Pascual, J. C., Feilding, A., Navarro-Gil, M., & Riba, J. (2018). Four weekly ayahuasca sessions lead to increases in ‘acceptance’ capacities: A comparison study with a standard 8-week mindfulness training program. Frontiers in Pharmacology, 9(MAR), 1–8. https://doi.org/10.3389/fphar.2018.00224
Soler, J., Elices, M., Franquesa, A., Barker, S., Friedlander, P., Feilding, A., & Riba, J. (2016). Exploring the therapeutic potential of Ayahuasca: Acute intake increases mindfulness-related capacities. Psychopharmacology, 233(5), 823–829. https://doi.org/10.1007/s00213-015-4162-0
Stauffer, C. S., Anderson, B. T., Ortigo, K. M., & Woolley, J. (2021). Psilocybin-assisted group therapy and attachment: Observed reduction in attachment anxiety and influences of attachment insecurity on the psilocybin experience. ACS Pharmacology and Translational Science, 4(2), 526–532. https://doi.org/10.1021/acsptsci.0c00169
Stokke, C., & Rodriguez, M. C. (2021). Spiritual awakening experiences: A phenomenological study in transpersonal psychology. Self & Society, 49(2), 9-25.
Swift, T. C., Belser, A. B., Agin-Liebes, G., Devenot, N., Terrana, S., Friedman, H. L., & Ross, S. (2017). Cancer at the dinner table: Experiences of psilocybin-assisted psychotherapy for the treatment of cancer-related distress. Journal of Humanistic Psychology, 57(5), 488–519. https://doi.org/10.1177/0022167817715966
Thal, S. B., Bright, S. J., Sharbanee, J. M., Wenge, T., & Skeffington, P. M. (2021). Current perspective on the therapeutic pre-set for substance-assisted psychotherapy. Frontiers in Psychology, 12(July), 1-16. https://doi.org/10.3389/fpsyg.2021.617224
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., & Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Watts, R., Day, C., Krzanowski, J., Nutt, D., & Carhart-Harris, R. (2017). Patients’ accounts of increased “connectedness” and “acceptance” after psilocybin for treatment-resistant depression. Journal of Humanistic Psychology, 57(5), 520–564. https://doi.org/10.1177/0022167817709585
Watts, R. (2020). The use of the psychological flexibility model to support psychedelic assisted therapy. Journal of Contextual Behavioral Science, 15, 92-102. https://doi.org/10.1016/j.jcbs.2019.12.004
Wheeler, S., & Dyer, N. (2020). A systematic review of psychedelic-assisted psychotherapy for mental health: An evaluation of the current wave of research and suggestions for the future. Psychology of Consciousness: Theory, Research, and Practice, 7, 1-39. http://dx.doi.org/10.1037/cns0000237
Ziff, S., Stern, B., Lewis, G., Majeed, M., & Gorantla, V. R. (2022). Analysis of psilocybin-assisted therapy in medicine: A narrative review. Cureus, 14(2), 1-12. https://doi.org/10.7759/cureus.21944
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Nicole Schuitmaker
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
